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Bladder cancer

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Bladder cancer starts in the lining of the bladder, the organ that holds urine. At Atrium Health Floyd and Harbin Clinic, our urologic cancer specialists expertly diagnose and treat all types of bladder cancer. 

What is bladder cancer? 

Bladder cancer occurs when cells in the lining of your bladder change and grow uncontrollably. Your bladder is the organ that holds urine until you pee. Bladder cancer starts in the urothelium, the tissue that lines the inside of the bladder. 

Causes of bladder cancer  

Like many cancers, experts aren’t sure why some people develop bladder cancer. Bladder cancer sometimes affects members of the same family, which suggests a possible genetic risk.  

The cancer occurs when bladder cells change. These changed cells quickly grow and divide into new cells, causing cancer.  

Bladder cancer symptoms 

Common signs of bladder cancer include: 

  • Abdominal pain 
  • Blood in the urine 
  • Difficult or painful urination 
  • Frequent urination or urgent need to pee 
  • Leaking urine (urinary incontinence) 
  • Lower back pain 
  • Persistent bladder infections Unintended weight loss 

Bladder cancer types 

The cells where cancer starts determine the type of bladder cancer. Types of bladder cancer include: 

  • Urothelial carcinoma: Also called transitional cell carcinoma, this is the most common type of bladder cancer. The cancer starts in the urothelial cells that line the bladder. The cancer may spread deeper into the bladder or through the bladder wall into surrounding fatty tissue. 
  • Adenocarcinoma: This type of cancer starts in cells that form glands in the bladder wall. 
  • Sarcoma: This rare cancer type starts in muscle cells in the bladder. 
  • Small cell carcinoma: This rare cancer type starts in nerve-like neuroendocrine cells. 
  • Squamous cell carcinoma: In this type, thin, flat cancer cells form in the bladder lining.  

Bladder cancer diagnosis 

Your doctor will perform a physical exam and ask about your symptoms and medical history. They will then run several tests to reach a cancer diagnosis. 

Tests that can help your doctor diagnose bladder cancer include: 

  • Urine tests (urinalysis) to rule out infections and look for signs of blood in your urine 
  • Urine cytology to check for cancer cells in a urine sample 
  • Urine tumor marker (biomarker) test to look for tumor markers that indicate cancer in a urine sample 
  • Imaging tests, such as abdominal CT scan and MRI, to view the bladder 
  • Cystoscopy, which involves using a scope device to view the inside of the bladder and remove cell samples to check for cancer under a microscope (biopsy) 
  • Transurethral resection of bladder tumor (TURBT) to remove bladder tumors for additional testing and help determine the cancer stage 

Bladder cancer staging 

After a bladder cancer diagnosis, doctors determine whether the cancer has spread outside the bladder. This process, called cancer staging, helps guide treatment decisions. 

Stages of bladder cancer include: 

  • TA: Cancer is only in the bladder lining and hasn’t spread.  
  • T1: Cancer has spread through the bladder lining but doesn’t affect the bladder muscle. 
  • T2: Cancer has spread to the bladder muscle. 
  • T3: Cancer has spread through the bladder into fatty tissue surrounding it. 
  • T4: Cancer has spread to nearby structures, such as the prostate gland, uterus, vagina, rectum, abdominal wall or pelvic wall. 

Doctors also determine a grade for the tumors based on how they look under a microscope. A high-grade tumor grows fast and is more likely to spread. 

Bladder cancer risk factors 

Certain factors may increase your risk of developing bladder cancer, including: 

  • Chemotherapy or radiation therapy to treat other types of cancer 
  • Exposure to certain chemicals, such as those found in dyes, pesticides, and aluminum, rubber and leather products  
  • Family history of bladder cancer 
  • Frequent bladder infections or bladder stones 
  • Prolonged use of urinary catheters 
  • Smoking or exposure to secondhand smoke 

Complications of bladder cancer  

Bladder cancer, and its treatments, can cause complications like: 

  • Sexual dysfunction 
  • Urethral stricture (narrowing of the tube that carries urine from the bladder out of the body) 
  • Urinary incontinence (loss of bladder control) 

Bladder cancer treatment

Bladder cancer treatments depend on the cancer stage, the severity of your symptoms and your overall health. Surgery is a common treatment for bladder cancer. Types of surgery include:

  • Transurethral resection of bladder tumor (TURBT): During TURBT, a doctor removes cancer tumors using a scope device.
  • Cystectomy: In some cases, a doctor may remove part of the bladder (partial cystectomy) or the entire bladder (radical cystectomy). You’ll also have surgery to create a new bladder (neobladder) or a urinary diversion so you can pee.

Other bladder cancer treatments may include:

  • Intravesical therapy to deliver chemotherapy directly into the bladder
  • External beam radiation therapy to kill cancer cells in the bladder
  • Immunotherapy to help your immune system find and destroy cancer cells
  • Systemic chemotherapy to kill cancer cells throughout the body
  • Targeted therapy to destroy cancer cells with specific cancer-causing gene changes

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